Remote ischemic preconditioning of transplant recipients to reduce graft ischemia and reperfusion injuries: A systematic review

Transplant Rev (Orlando). 2018 Jan;32(1):10-15. doi: 10.1016/j.trre.2017.06.001. Epub 2017 Jun 15.

Abstract

Background: Solid organ transplantation is an accepted treatment for end-stage solid organ diseases. During the procedure, ischemia and reperfusion injury may affect graft and patient outcomes. Remote ischemic preconditioning (rIC) has been shown to reduce ischemia and reperfusion injury and can be performed safely. Thus, rIC may potentially improve outcomes after solid organ transplantation. Traditionally, the focus of rIC has been on the donor. However, preconditioning the recipient may be a more suitable approach in transplant settings. The current review analyzed previously published studies where rIC was performed on transplant recipients.

Methods: PubMed and EMBASE databases were searched for eligible clinical and animal studies evaluating rIC of recipients. Articles were analyzed and compared qualitatively. Risk of bias was assessed using the Cochrane Collaboration's tool for interventional clinical studies and SYRCLEs risk of bias tool for animal studies.

Results: A total of 12 studies were included. Overall, these studies were heterogeneous due to differences in populations and intervention set-up. Some of the studies suggested improvement of graft function, while other studies did not show any effect. The quality of the 12 included studies was predominantly low.

Conclusion: Due to the heterogeneity and quality of the included studies the result, that rIC may be beneficial in transplantation of some organs, should be interpreted with caution. The result must be confirmed by further clinical studies.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Animals
  • Humans
  • Ischemic Preconditioning / methods*
  • Kidney Transplantation*
  • Reperfusion Injury / prevention & control*
  • Tissue Donors*
  • Transplant Recipients*